Healthcare Provider Details

I. General information

NPI: 1518416593
Provider Name (Legal Business Name): PERFECT PIECE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2016
Last Update Date: 12/16/2021
Certification Date: 12/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 CEDAR HILL ST SUITE 200
MARLBOROUGH MA
01752-5900
US

IV. Provider business mailing address

225 CEDAR HILL ST SUITE 200
MARLBOROUGH MA
01752-5900
US

V. Phone/Fax

Practice location:
  • Phone: 508-773-7279
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number1078
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number1078
License Number StateMA

VIII. Authorized Official

Name: JERMAINE HENDERSON
Title or Position: PRESIDENT
Credential:
Phone: 508-733-7279